PacifiCare Health Systems, Santa Ana, Calif., will distribute $14 million early this month as its first reimbursement under a California pay-for-performance initiative it launched last year to reward physician groups that improve quality of care and service to its members.
The payment will be distributed among 124 medical groups that scored above the 75th percentile on 16 measures of preventive care, disease management, hospital safety and patient satisfaction, the insurer announced last week. Subsequent reward payments will be made quarterly.
Medical groups have improved quality and satisfaction by 28% in 12 of the 16 measures since the voluntary program began, PacifiCare said.
The company's efforts are related to a broader statewide pay-for-performance initiative formally launched in January in conjunction with the Integrated Healthcare Association, a Walnut Creek, Calif.-based managed-care policy development group, and five other HMOs: Aetna, Blue Cross of California, Blue Shield of California, Cigna Corp and Health Net.
Under the IHA program, the HMOs will pay a total of $150 million annually to medical groups that excel on a number of standardized measures. A statewide scorecard will be published next year, comparing how all participating medical groups stacked up in 2003.